Individual provider Active NPI

Esmaeil Ben Kamali, FNP

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1770968760
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6627-33 Issued in WI
Practice address
725 S Webster Ave Ste 201
Green Bay, WI 54301-3500
Phone
(920) 430-7100
Fax
(920) 430-7114
NPI assigned
Jul 20, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6627-33 WI Primary

Addresses

Primary practice location

725 S Webster Ave Ste 201
Green Bay, WI 54301-3500

Mailing address

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (678) 779-7038

Other practice location 1

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

Other practice location 2

1630 Commanche Ave Ste 12
Green Bay, WI 54313-5753
Phone (920) 433-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151105001490 WI Practitioner - Nurse Practitioner 9335459270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

2020 S Webster Ave
Accounting
Green Bay, WI 54301-3505

3415 Custer St D
Manitowoc, WI 54220-4356
Phone (920) 652-9310

725 S Webster Ave
Suite 201
Green Bay, WI 54301-3500
Phone (920) 430-7100

744 S Webster Ave
Green Bay, WI 54301-3505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Nov 1, 2017 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Sep 16, 2017 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Sep 16, 2017 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Nov 1, 2017 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

1630 Commanche Ave
Ste 12
Green Bay, WI 54313
Phone (920) 433-6000

725 S Webster Ave
Ste 201
Green Bay, WI 54301
Phone (920) 430-1700

1765 N 18th St
Manitowoc, WI 54220
Phone (920) 482-0575

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

833 S Main St
Oconto Falls, WI 54154
Phone (920) 338-6866

Interoperability endpoints

  • Direct secure messaging: ekamali167075@direct.thedacare.org
  • Direct secure messaging: ekamali917033@direct.emplifyhealth.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1770968760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "678-779-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WEBSTER AVE STE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013500",
            "telephone_number": "920-430-7100",
            "fax_number": "920-430-7114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2820 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433834",
            "country_code": "US",
            "telephone_number": "715-735-5225",
            "fax_number": "715-735-5388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 Commanche Ave Ste 12",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135753",
            "country_code": "US",
            "telephone_number": "920-433-6000",
            "fax_number": "920-430-4719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMALI",
        "first_name": "ESMAEIL",
        "middle_name": "BEN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-20",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6627-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.